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Basics > Anesthesia Machine > Flashcards

Anesthesia Machine Flashcards

1
Q

State purpose of Hanger Yoke Assembly

A
  • Ensures gas tight seal

- orients cylinder (PISS)

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2
Q

Purpose of PISS

A

prevents misconnection of a cylinder to the wrong yoke

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3
Q

Purpose of a Hanger Yoke check valve

A
  • free floating valve (opens & closes w/ press)
  • prevents retrograde gas flow
  • allow change of cylinders during use
  • minimize gas leaks to atmosphere if a yoke is empty
  • minimize trans-filling of gases
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4
Q

Purpose of minimizing trans-filling of gases

A
  • prevents a full cylinder from emptying into an empty cylinder
  • prevents wall O2 from entering an empty cylinder
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5
Q

How is cylinder pressure measured?

A

Bourdon press gauge

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6
Q

What is the PSI of O2?

A

2000-2200

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7
Q

What is the PSI of N2O

A

750 PSI

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8
Q

Purpose of cylinder press regulator

A

converts cylinder press to a constant press of 45 PSIG downstream of regulator

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9
Q

N2O will read what PSIG?

A

It will read 745 PSIG until all the liquid in the cylinder has vaporized to gas

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10
Q

What can be assumed with a N2O reading < 745 PSIG

A

That 75% of N2O cylinder gas has been exhausted

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11
Q

Can the volume of N2O cylinder be determined based on the PSIG?

A

No

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12
Q

What happens if a pressurized gas falls below a critical value (critical temp)

A

The molecules will get close together and form liquid

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13
Q

What happens if a pressurized gas rises above the critical value called critical temp

A

The molexules will not get close enough and stay in a gaseous state

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14
Q

What the crtical temp of O2 an N2O

A

O2 -119 C

N2O 39.5 C

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15
Q

Purpose of DOT

A

estabiling criteri for design, labeling and storage of tanks

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16
Q

Who issus standards to protect the health and safety of workers?

A

NIOSH & OSHA

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17
Q

PSIG of O2

A

2200

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18
Q

PSIG of N2O

A

745

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19
Q

PSIG of Air

A

1900

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20
Q

What is the sequence of the O2 flowmeter tube?

A

O2 is always to the right or downstream of all other gases and closest to the manifold outlet

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21
Q

Why are flow valves linked mechanically or pneumtically?

A
  • So O2 cannot be set below 25%
  • ensures adequate % of O2 delivery
  • O2 flow control spindle is connected to the N2O spindle
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22
Q

Result of O2 spindle being connected to N2O spindle

A
  • If you increase N2O flow, O2 flow will increase
  • if you increase O2 flow, N2O will not increase
  • If you decrease N2O flow, O2 fow wll not decrease
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23
Q

What is heat of vaporization?

A

The # of calories required at a specific temp to convert 1G of liquid to vapor

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24
Q

Why does relief gas valve exist?

A

It will open if gas flow exceeds that which is required for delivery of gas concentration on dial

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25
Q

Why does the temp compensating bypass valve exist?

A

It will open and allow gas to bypass vaporizer chamber

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26
Q

The vaporizer should not be tilted beyond how many degrees and why?

A

45 degrees. If it does the vaporizer must be drained and dried or can deliver uncertain % of anesthetic agent

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27
Q

The vaporizer interlock ensures that…

A
  • Only 1 vaporizer is turned on
  • Gas enters only the one which is on
  • Trace vapor output is minimized when the vaporizer is off
  • vaporizers are locked into the gas circuit , ensuring they are seated correctly
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28
Q

Purpose of vaporizer interlock mechanism

A

Safety mechanism that allows only one vaporizer at a time to be opened

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29
Q

What happens if the wrong agent were placed in a vaporizer? and what must you do if this occurs?

A

It will deliver an unknown concentration of agent to pt

-Must empty, flush w/ 100% O2 and dry

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30
Q

What is HLH?

A

Higher VP agent in lower VP vaporizer chamber

- higher concentration will be delivered

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31
Q

What is LHL?

A

Lower VP agent in higher VP vaporizer chamber

-lower concentration delivered

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32
Q

What is the function of any breathing system?

A

To deliver O2 an anesthetic gases and eliminate CO2

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33
Q

How is CO2 washout accomplished?

A

Either with adequate FGF or by soda lime absorption

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34
Q

Purpose of APL valve (pop-off valve)

A

Limits amt of pressure inside the pts lungs during manual ventilation
- if pressure reaches the setting of the APL knob, the valve opens and allows excess gas to escape to the scavenging system

35
Q

What direction would you turn the APL valve to increase or decrease the pressure?

A

Turning knob to right (closing) increases the pressure

- Turning knob to left (opening) decreases the pressure

36
Q

What is th mesh size of soda lime?

A

4-8

37
Q

What is the mesh size of baralyme?

A

4-8

38
Q

What is the method of hardness of soda lime?

A

silica added

-minimize dust formation

39
Q

What is the method of hardness of baralyme?

A

Bound water of crytallization

40
Q

What are the contents of soda lime?

A

NaOH 4%
KOH 1%
CaOH 95%

41
Q

What are the contents of baralyme?

A

CaOH 80%

BaOH 20%

42
Q

What is the absorptive capacity (L of CO2/100G granules) of soda lime?

A

14-23

43
Q

What is the absorptive capacity (L of CO2/100G granules) of baralyme?

A

9-18

44
Q

Characteristics of AMSORB

A
  • CaOH
  • CaCL
  • doesn’t form compound A or carbon monoxide
45
Q

What are the final products of CO2 neutralization?

A

Carbonates + water + heat

CaCO3+2 H2O + Heat

46
Q

List factors increasing compound A

A
  • total gas flow rates below 1L/min
  • use of baralyme rather than soda lime
  • high absorbent of sevoflurane
  • drying of the CO2 absorbent
  • length of anesthetic
47
Q

Which gases produce carbon monoxide?

A

Desflurane>Enflurane>Isoflurane with absorbents produces carbon monoxide

-high concentrations w/ absorber that haven’t been used for 24 hrs or more

48
Q

factors increasing Carbon monoxide

A
  • use of baralyme rather soda than soda lime
  • higher temps in absorber
  • dry absorbent
  • higher anesthetic concentrations
  • increasing length of time
49
Q

Purpose of selector valve

A

Allows the selecton of manual or mechanical ventilation

-isolates APL valve from rest of system

50
Q

what is TV?`

A

volume of gas entering or leaving the pt during inspiratory or expiratory phase time

51
Q

what is MV?

A

sum of tidal volumes in one minute

52
Q

What is ventilatory frequency?

A

number of respiratory cycles per minute

53
Q

what is inspiratory pause time

A

period from the end of inspiratory flow to the start of expiratory flow

54
Q

what is inspiratory phase time?

A

period of time b/w the start of inspiratory flow and the beginning of expiratory flow or it is the sum of the inspiratory flow time and the inspiratory pause time

55
Q

what is the expiratory pause time ?

A

interval from the end of expiratory flow to the start of inspiratory flow

56
Q

What is the expiratory phase tijme?

A

time b/w the start of expiratory flow and the start of inspiratory flow or it is the sum of the expiratory flowtime and the expiratory pause time

57
Q

what is the inspiratory and expiratory phase time ratio?

A

I:E ratio is the ratio of inspiratory phase time to expiratory phase time

58
Q

what is the inspiratory flow rate?

A

volume of gas per unit time that passes from th pt connection of the breathing system to the pt

59
Q

what is the expiratory flow rate?

A

volume of gas per unit time returned from the pt during the expiratory phase

60
Q

What is resistance?

A

pressure diff per unit flow across the airway

-it usally increases as flow increases

61
Q

what is compliance?

A

ratio of a change in volume to a change in pressure

62
Q

Purpose of bellows

A

separates breathing system gases from driving gas

63
Q

Describe Ascending (standing) bellows

A
  • most commonly used

- rise (fill) during expiration and fall (empty) during inspiration

64
Q

Describe Descendin (hanging) bellows

A
  • unrecognizable pt disconnection

- bellows will continue to fill and empty even when the pt is disconnected from the vent

65
Q

Name two sets of gases in the ventilator

A
  • Driving gas - outside the bellows

- Patient gas - inside the bellow

66
Q

Normal range of tidal volume

A

10-15 ml/kg (dependingon th ETCO2 and PIP)

67
Q

Describe I:E ratio

A

uses 1 for the inhalation time and an appropriate # expressing the relative length of exhalation time

68
Q

Purpose of scavenging systems

A
  • removes gasses vented from the breathing system

- minimizes venting of waste gases into the OR

69
Q

NIOSH recommends limiting room concentration of gases to be?

A
  • N2O - 25 ppm
  • Halogenated agents - 2 ppm
  • Halogenated agents with N2O - 0.5 ppm
70
Q

List the pressure systems of anesthesia machines

A
  • High
  • Intermediate
  • Low
71
Q

List components of high press system

A

Consists of those parts that rcv gas at cylinder pressure

  • hanger yoke
  • hanger yoke check valve
  • cylinder pressure regulator
  • cylinder pressure gauge
72
Q

List components of internedite pressure system

A

receives gas at relatively low and constant press (35-55 PSIG/pipeline press)

  • pipeline inlets and press gauges
  • vent power outlet accessory
  • O2 flush valve
  • supply failure alarm system
  • second stage press regulator
  • flowmeter valves
73
Q

List components of low press system

A

components distal to the flowmeter needle

  • flowmeter tubes
  • vaporizers
  • temp compensating bypass valve
  • common gas outlet
74
Q

When must a high priority alarm sound?

A
  • if user adjustable limits are exceeded
  • if continuing high pressure alarm is sensed
  • for negative pressure
75
Q

What are disconnect alarms based on?

A
  • low pressure
  • exhaled volume
  • carbon dioxide
76
Q

List the required monitors

A
  • exhaled volume
  • inspired O2 - w/ a high priority alarm w/in 30 sec of O2 falling below 18% (or a user adjustable limit)
  • O2 supply failure alarm
  • a hypoxic guard system must protect aganst less than 21% inspire O2 if nitrous is in use
  • Pulse ox, BP, and EKG are also required
77
Q

What is th PSI of O2 when it enters the anesthesia machine from the central supply source?

A

45-55 PSI

78
Q

Where should check valves on the machine be located?

A

Downstream from the pipeline inlet to prevent reverse flow of gases thereby avoiding flow of gas from the machine to wall supply

79
Q

What occurs when O2 from the E cylinder passes through the hanger yoke check valve and cylinder pressure regulator?

A

the pressure from the cylinder (2000 psi) is reduced to 40-50 PSI

80
Q

Describ the wood’s metal cylinder

A

a safety device that melts under excessive heat (>200 F) to allow the gas to escape preventing an explosion

81
Q

what is the joule thompson effect?

A

a cooling effect once compressed gas is allowed to escape in open spaces

82
Q

what is adiabatic heat of compression?

A

compression of cylinder contents into a small space generates heat and may cause combustion1

83
Q

who develops the purity specs of gases?

A

US pharmacopecia and national formulary

Basics (2 decks)

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